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Pourfour du Petit Syndrome

A Rare Association With Cluster Headache

Nadal, Jeremy, M.D.*,†; Daien, Vincent, M.D., Ph.D.‡,§; Audemard, Didier, M.D.*; Jeanjean, Luc, M.D.*

Ophthalmic Plastic & Reconstructive Surgery: January/February 2019 - Volume 35 - Issue 1 - p e15–e16
doi: 10.1097/IOP.0000000000001281
Case Reports

Pourfour du Petit syndrome is an uncommon cause of eyelid retraction, associated with unilateral mydriasis and hemifacial hyperhidrosis. This syndrome is caused by hyperactivity of the ipsilateral oculosympathetic pathway and needs to be recognized because it has an opposite clinical presentation but the same topographic and diagnostic value as Horner syndrome. The authors report a rare case of Pourfour du Petit syndrome associated with cluster headache and discuss pathophysiological hypotheses, clinical presentation, complementary exams, pharmacologic testing, treatment options, and prognosis. Early detection of these symptoms may lead to swift diagnosis and treatment.

The authors report a case of Pourfour du Petit syndrome (PDP), a rare cause of eyelid retraction, and discuss clinical feature, management, and outcome. The association with cluster headache has not been described previously.

*Department of Ophthalmology, Nîmes University Hospital, Nîmes Cedex 9

I2FH, Institut d’Imagerie Fonctionnelle Humaine, Montpellier University Hospital Center, Gui de Chauliac Hospital, Montpellier

Department of Ophthalmology, Gui De Chauliac Hospital, Montpellier

§INSERM, University of Montpellier, Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France

Accepted for publication October 4, 2018.

The authors have no financial or conflicts of interest to disclose.

Address correspondence and reprint requests to Jeremy Nadal, M.D., Service d’ophtalmologie, Hôpital Caremeau, Centre Hospitalier Universitaire de Nîmes, 4 rue du Pr Debré, 30029, Nimes Cedex 9, France. E-mail:

© 2019 by The American Society of Ophthalmic Plastic and Reconstructive Surgery, Inc., All rights reserved.